Abnormal N-acetylaspartate in hippocampus and anterior cingulate in posttraumatic stress disorder

Schuff, Norbert; Neylan, Thomas C.; Fox-Bosetti, Sabrina; Lenoci, Maryanne; Samuelson, Kristin W.; Studholme, Colin; Kornak, John; Marmar, Charles R.; Weiner, Michael W.

doi:10.1016/j.pscychresns.2007.04.011

« Previous Next »Psychiatry Research: Neuroimaging
Volume 162, Issue 2 , Pages 147-157, 28 February 2008

Abnormal N-acetylaspartate in hippocampus and anterior cingulate in posttraumatic stress disorder

Norbert Schuff
- Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA, USA
- Department of Radiology, University of California, San Francisco, CA, USA
- Corresponding author. DVA Medical Center, 4150 Clement St. 114M, San Francisco, CA 94121, USA. Tel.: +1 415 221 4810x4904; fax: +1 415 668 2864.
Thomas C. Neylan
- Mental Health Service, DVA Medical Center, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
Sabrina Fox-Bosetti
- Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA, USA
Maryanne Lenoci
- Mental Health Service, DVA Medical Center, San Francisco, CA, USA
Kristin W. Samuelson
- California School of Professional Psychology, Alliant International University, San Francisco, CA, USA
Colin Studholme
- Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA, USA
- Department of Radiology, University of California, San Francisco, CA, USA
John Kornak
- Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA, USA
- Department of Radiology, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
Charles R. Marmar
- Mental Health Service, DVA Medical Center, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Department of Radiology, University of California, San Francisco, CA, USA

Received 29 November 2006; received in revised form 23 April 2007; accepted 24 April 2007.

Abstract

Magnetic resonance spectroscopic imaging (MRSI) studies suggest hippocampal abnormalities in posttraumatic stress disorder (PTSD), whereas findings of volume deficits in the hippocampus, as revealed with magnetic resonance imaging (MRI), have been inconsistent. Co-morbidities of PTSD, notably alcohol abuse, may have contributed to the inconsistency. The objective was to determine whether volumetric and metabolic abnormalities in the hippocampus and other brain regions are present in PTSD, independent of alcohol abuse. Four groups of subjects, PTSD patients with (n=28) and without (n=27) alcohol abuse and subjects negative for PTSD with (n=23) and without (n=26) alcohol abuse, were enrolled in this observational MRI and MRSI study of structural and metabolic brain abnormalities in PTSD. PTSD was associated with reduced N-acetylaspartate (NAA) in both the left and right hippocampus, though only when normalized to creatine levels in the absence of significant hippocampal volume reduction. Furthermore, PTSD was associated with reduced NAA in the right anterior cingulate cortex regardless of creatine. NAA appears to be a more sensitive marker for neuronal abnormality in PTSD than brain volume. The alteration in the anterior cingulate cortex in PTSD has implications for fear conditioning and extinction.